Individual provider Active NPI

Laura Elizabeth Vandenberg, OD

  • Optometrist
  • Tampa, FL
National Provider Identifier
1730867607
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6087 Issued in FL
Practice address
13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446
Phone
(813) 908-2020
Fax
(813) 908-2133
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6087 FL Primary

Addresses

Primary practice location

13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446

Mailing address

13904 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2446
Phone (813) 908-2020

Other names 1

  • Laura Hedrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724004034 FL Practitioner - Optometry 0244690121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newsom Eye and Laser Center IncGroup PAC ID 0648241190, 16 clinicians

Practice addresses (Care Compare)

13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone (813) 908-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6087FLMDOptometrist
OPC6154FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Newsom Eye & Laser Center Inc Optometrist CurrentSince Sep 1, 2023 Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist CurrentSince Sep 1, 2023 Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist Past Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist Past Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist Past Accepting new patients
Newsom Eye & Laser Center, Inc. Optometrist Past Accepting new patients

Locations

14543 Cortez Blvd
Brooksville, FL 34613
Phone (352) 596-4030

4211 US 27 N
Sebring, FL 33870
Phone (863) 385-1544

113 S Armenia Ave
Tampa, FL 33609
Phone (813) 908-2020

13904 N Dale Mabry Hwy
Ste 200
Tampa, FL 33618
Phone (813) 908-2020

Interoperability endpoints

  • Direct secure messaging: lhedrick@newsomeyelaser.intellechartdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1730867607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "HEDRICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.